Individual provider Active NPI

David Robert Anderson, DO

  • Family Medicine Physician
  • Fort Sill, OK
National Provider Identifier
1780788158
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3126 Issued in OK
Practice address
4301 Mow-Way Road
Reynolds Army Community Hospital(Attn:McUa-QC,Ms Presco
Fort Sill, OK 73503-6300
Phone
(580) 458-2134
Fax
(580) 458-2314
NPI assigned
Sep 7, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3126 OK Primary

Addresses

Primary practice location

4301 Mow-Way Road
Reynolds Army Community Hospital(Attn:McUa-QC,Ms Presco
Fort Sill, OK 73503-6300

Mailing address

4301 Mow-Way Road
Reynolds Army Community Hospital(Attn:McUa-QC,Ms Presco
Fort Sill, OK 73503-6300
Phone (580) 458-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140917002890 OK Order and Referring Only - Family PracticePractitioner - Family Practice 3274752605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1780788158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 MOW-WAY ROAD",
            "address_2": "REYNOLDS ARMY COMMUNITY HOSPITAL(ATTN:MCUA-QC,MS PRESCO",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735036300",
            "telephone_number": "580-458-2134",
            "fax_number": "580-458-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MOW-WAY ROAD",
            "address_2": "REYNOLDS ARMY COMMUNITY HOSPITAL(ATTN:MCUA-QC,MS PRESCO",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735036300",
            "telephone_number": "580-458-2134",
            "fax_number": "580-458-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sill, OK

Sources for this page

Verify at the official NPI Registry.